RHINO ENERGY [ HSE/DSTI ]

• Site conducted

• Conducted on

  Date

• Prepared by

• Location
  Address

• Safe access to work area clean & tidy - Safe Access & egress

  Yes

  No

  CORRECTIVE MEASURES

  DATE

• Electrical equipment in good condition <br>Pre-Use inspection completed Fit for the purpose

  Yes

  No

  CORRECTIVE MEASURES

  DATE

• Plant & Equipment in good condition Machine guarding adequate <br>Pre-Use inspection completed Fit for the purpose

  Yes

  No

  CORRECTIVE MEASURES

  DATE

• Lifting equipment Fit for the purpose <br> Good & Safe condition (valid load test ) <br> Equipment pre-Use inspection completed

  Yes

  No

  CORRECTIVE MEASURES

  DATE

• Elevated work Safe ladder / Scaffolding <br> Effective

  Yes

  No

  CORRECTIVE MEASURES

  DATE

• Lock-Outs / Tag-Outs

  Yes

  No

  CORRECTIVE MEASURES

  DATE

• PPE Pre-use inspections completed <br> Good & safe condition <br> Fit for the purpose

  Yes

  No

  CORRECTIVE MEASURES

  DATE

The above list does not exclude and or wave any other checklist and or legal requirements!

CURRENT JOB'S

• LIST MAIN STEP'S OF TASK?

WHAT ARE THE HAZARD'S

• JOB & ENVIRONMENT?

LIST CONTROL'S REQUIRED

• IMPLEMENTED?

NAME AND SURNAME

• Add signature

  Sign

• NOTE : IF TASKS CHANGE , THIS LIST AND RISK ASSESSMENT MUST BE REVISED BEFORE PROCEEDING WITH NEW/CHANGED TASK.
  A SIGNED ATTENDANCE REGISTER MUST BE ATTACHED TO THIS LIST.
  I HEREBY CERTIFY THAT THE ABOVE ITEMS WERE CHECKED AND ALL WORKERS UNDER MY SUPERVISION RECEIVED A SAFE TASK INSTRUCTION: